RESUMO
BACKGROUND: Few studies evaluated the use of Household Disinfectant and Cleaning Products (HDCPs) during the COVID-19 pandemic, but no population-based cohorts used longitudinal data. We studied changes in HDCPs during the first lockdown, based on longitudinal data from the French population-based NutriNet-Santé and CONSTANCES cohorts. METHODS: Based on standardized questionnaires on household cleaning tasks in 2018-2019 and around the first lockdown in France (March17-May3 2020), we compared the duration of weekly use of HDCPs (< 1 day/week, < 10 min/week; 10-30 min/week; > 30 min/week) and the household cleaning help (yes/no) before and during the lockdown period by Bhapkar and McNemar's tests. Moreover, we assessed self-reported changes in the frequency of HDCPs during the lockdown from before (unchanged/increased). RESULTS: Analyses were carried on 31,105 participants of NutriNet-Santé (48 years, 75% women, 81% ≥ high school diploma) and 49,491 of CONSTANCES (47 years, 51% women, 87% ≥ high school diploma). During the lockdown, compared with 2018-2019, duration of HDCPs use increased (> 30 min; NutriNet-Santé: 44% versus 18%; CONSTANCES: 63% versus 16%) and household help decreased (NutriNet-Santé: 5% versus 40%; CONSTANCES: 3% versus 56%). Regarding the frequency of HDCPs use, 55% of participants of NutriNet-Santé (57% women/49% men) and 83% of CONSTANCES (86% women/81% men) reported an increased use since the beginning of the lockdown, significantly higher among women (p < 0.0001). CONCLUSIONS: The frequency and duration of weekly use of HDCPs has significantly increased since the pandemic. As the use of HDCPs is associated with health issues, further studies are now needed to evaluate the potential health impacts of these changes.
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COVID-19 , Desinfetantes , Humanos , França/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Masculino , Pessoa de Meia-Idade , Quarentena , Adulto , Detergentes , Estudos Longitudinais , Controle de Doenças Transmissíveis/métodos , Inquéritos e Questionários , Produtos Domésticos , SARS-CoV-2 , Zeladoria/estatística & dados numéricos , PandemiasRESUMO
Since there is no certainty about when the coronavirus disease 2019 (COVID-19) lockdown will be affected by health risk behaviors, so we investigate the effect of COVID-19-related health risk behavior changes using school-based self-reported data from a nationally representative South Korean adolescent population. We analyzed web-based self-reported data from the Korea Youth Risk Behavior Web-based Survey in 111,878 participants (57,069 in COVID-19 prepandemic); 54,809 in during the COVID-19 pandemic. This study included 12 to 18-year-olds. Self-report questionnaires were used to assess socioeconomic status, health risk behaviors, and psychological factors. Health risk behaviors such as alcohol consumption, substance use, and sexual experience significantly decreased in COVID-19 pandemic than in COVID-19 prepandemic. Psychosomatic changes such as stress levels, violence experience, depression, suicidal ideation, suicidal plans, and suicide attempts were significantly lower in COVID-19 pandemic compared to COVID-19 prepandemic (Pâ <â .001). After adjusting for multiple confounding variables, less alcohol consumption (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.88-0.93), less exercise (OR = 0.92; 95% CI = 0.89-0.94), less sexual experience (OR = 0.82; 95% CI = 0.77-0.86), less violence experience (OR = 0.61; 95% CI = 0.55-0.67), less stress (OR = 0.86; 95% CI = 0.84-0.88), less depression (OR = 0.85; 95% CI = 0.83-0.88), less suicidal ideation (OR = 0.93; 95% CI = 0.89-0.97), plans (OR = 0.82; 95% CI = 0.76-0.88), attempts (OR = 0.78; 95% CI = 0.71-0.85) were significantly associated with the COVID-19 pandemic compared to COVID-19 prepandemic. The COVID-19 pandemic was associated with changes in health risk behaviors among Korean adolescents, resulting in alcohol drinking, sexual experience, drug use, violence experience, and suicidal behaviors (idea, plan, and attempts) being decreased during the lockdown period.
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COVID-19 , Comportamentos de Risco à Saúde , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Adolescente , República da Coreia/epidemiologia , Feminino , Masculino , Criança , SARS-CoV-2 , Comportamento do Adolescente/psicologia , Autorrelato , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Pandemias , Inquéritos e Questionários , Ideação Suicida , Controle de Doenças Transmissíveis/métodosRESUMO
This article explores how Mao-era China responded to major epizootic and zoonotic diseases. It foregrounds a series of patterns in fighting contagious animal diseases-lockdowns, quarantines, disinfection, mass animal vaccination, mass education, and prioritizing the treatment of infected animals over mass culling-which were together called the Comprehensive Prevention and Treatment (CPT). Shedding light on this understudied topic in the fields of the history of medicine and of the People's Republic of China (PRC), the author argues that it was not the central or provincial governments but rather local communes that led the effort to protect livestock from animal infectious diseases. This article critically demonstrates how the story of the CPT highlights the resilience of communal actors as well as the possibilities and limitations of the Maoist ideal of self-reliance.
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Doenças Transmissíveis , Animais , China , História do Século XX , História do Século XIX , Doenças Transmissíveis/história , Zoonoses/história , Plantas Medicinais , Controle de Doenças Transmissíveis/história , Controle de Doenças Transmissíveis/métodos , Doenças dos Animais/história , Doenças dos Animais/prevenção & controle , História do Século XVIIIRESUMO
Worldwide, governments imposed non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic to contain the pandemic more effectively. We examined the effectiveness of individual NPIs in the United States during the first wave of the pandemic. Three types of analyses were performed. First, a prototypical Bayesian hierarchical model was employed to gauge the effectiveness of five NPIs and they are gathering restriction, restaurant capacity restriction, business closure, school closure, and stay-at-home order in the 42 states with over 100 deaths by the end of the wave. Second, we examined the effectiveness of the face mask mandate, the sixth and most controversial NPI by counterfactual modeling, which is a variant of the prototypical Bayesian hierarchical model allowing us to answer the question of what if the state had imposed the mandate or not. The third analysis used an advanced Bayesian hierarchical model to evaluate the effectiveness of all six NPIs in all 50 states and the District of Columbia, and thereby provide a full-scale estimation of the effectiveness of NPIs and the relative effectiveness of each NPI in the entire United States. Our results have enhanced the collective knowledge on the general effectiveness of NPIs in arresting the spread of COVID-19.
Assuntos
Teorema de Bayes , COVID-19 , Máscaras , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Estados Unidos/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , Controle de Doenças Transmissíveis/métodosRESUMO
Schistosomiasis was once hyper-endemic in Yunnan Province. Following concerted efforts for over 70 years, remarkable achievements have been made for schistosomiasis control in the province. In 2004, the Mid- and Long-term Plan for Schistosomiasis Prevention and Control in Yunnan Province was initiated in Yunnan Province, and the target for transmission control of schistosomiasis was achieved in the province in 2009. Following the subsequent implementation of the Outline for Key Projects in Integrated Schistosomiasis Control Program (2009-2015) and the 13th Five - year Plan for Schistosomiasis Control in Yunnan Province, no acute schistosomiasis had been identified in Yunnan Province for successive 12 years, and no local Schistosoma japonicum infections had been detected in humans, animals or Oncomelania hupensis snails for successive 6 years in the province by the end of 2020. The transmission of schistosomiasis was interrupted in Yunnan Province in 2020. This review summarizes the history of schistosomiasis, changes in schistosomiasis prevalence and progress of schistosomiasis control in Yunnan Province, and proposes the future priorities for schistosomiasis control in the province.
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Esquistossomose , China/epidemiologia , Humanos , Esquistossomose/prevenção & controle , Esquistossomose/transmissão , Esquistossomose/epidemiologia , Animais , Caramujos/parasitologia , Controle de Doenças Transmissíveis/métodosRESUMO
BACKGROUND: Infectious diseases persistently pose global threats, and it is imperative to accelerate the professionalization of public health workforce. This study aimed to develop and validate the infectious disease control competency scale (IDCCS) for public health professionals to fill a theoretical gap and elevate practical capabilities by informing public health professionals' development goals. METHODS: The initial item pool was generated through a literature review, and categorized into three dimensions (knowledge, practical skills, and leadership) based on the competency iceberg model and public health leadership framework. A two-round Delphi process was conducted to determine indicators within the scale. A pilot survey was utilized for item analysis and exploratory factor analysis (EFA). A formal survey was employed for confirmatory factor analysis (CFA). The weight value of each indicator was calculated using the analytic hierarchy process. RESULTS: An initial scale with three primary items, 14 secondary items, and 81 tertiary items was generated. Twenty experts participated in the two rounds of the Delphi process. Authority coefficients exceeded 0.9 in both rounds. Kendall's W was 0.29 and 0.19, respectively (both P < 0.001). Item analysis presented a Cronbach's Alpha of 0.98, with corrected item-total correlation coefficients ranging from 0.33 to 0.78. EFA demonstrated that cumulative variance explanations for the four primary dimensions (knowledge, practical skills, leadership, and personal quality) were 77.463%, 73.976%, 81.174%, and 68.654%, respectively. CFA indicated that all composite reliability values and average variance extracted surpassed 0.8 and 0.5, respectively. The standardized factor loadings of the items ranged from 0.630 to 0.977. Among the seven model fit indices, each of the four dimensions satisfied at least five criteria. A final three-level scale comprising four primary items, 14 secondary items, and 64 tertiary items was constructed. The weight values for the four primary items were 0.4064, 0.2878, 0.2082, and 0.0981, respectively. CONCLUSIONS: The IDCCS was established to evaluate the competencies of knowledge, practical skills, leadership, and personal quality for public health professionals in infectious disease control. This scale demonstrates good reliability and validity, and can be used for performance evaluation, recruitment processes, curriculum development, and individual self-assessment.
Assuntos
Técnica Delphi , Humanos , Competência Profissional/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Liderança , Saúde Pública/estatística & dados numéricos , Inquéritos e Questionários , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Reprodutibilidade dos Testes , Adulto , Feminino , MasculinoRESUMO
INTRODUCTION: During 2020-2021 Australia maintained comparatively low rates of COVID-19 in the community and residential aged care facilities (RAC) due to stringent public health measures such as lockdowns. However, the public health measures implemented may have had unintended impacts on critical RAC resident health outcomes, such as falls, due to routine care disruptions and aged care resident isolation. We utilised a longitudinal data to assess the association between COVID-19 lockdowns and the rate of falls in RAC settings. METHODS: A longitudinal cohort study was conduct using routinely collected data from 25 RAC facilities from one non-profit aged care provider in Sydney, Australia. The study included 2,996 long term residents between March 2019 and March 2021. The outcome measures were all falls, injurious falls, and falls assessed as requiring hospitalisation. Generalised estimating equations (GEE) were applied to determine the association between COVID-19 lockdown periods and fall-related outcomes while adjusting for confounders and seasonality. RESULTS: During the study period 11,658 falls were recorded. Residents frequently experienced at least one fall during the study period (median: 1, interquartile range: 0-4). During Lockdown 1 (March-June 2020) the rate of all falls increased 32% (IRR 1.32, 95% CI 1.19-1.46, p < 0.01) and the rate of injurious falls increased by 28% (IRR 1.28, 95% CI 1.12-1.46, p < 0.01) compared to pre-pandemic rates. The rate of falls assessed as requiring hospitalisation remained unchanged during Lockdown 1 (IRR 1.07, 95% CI 0.86-1.32, p = 0.519). During Lockdown 2 (Dec 2020-Jan 2021) the rate of all falls, injurious falls, and falls assessed as requiring hospitalisation did not change significantly compared to pre-pandemic rates. CONCLUSION: These findings suggest that the consequences of stringent COVID-19 restrictions, as seen in Lockdown 1, produced changes in residents' care which contributed to more falls and associated harm. The subsequent lockdown, which were less restrictive and occurred after staff had gained experience, was associated with no significant increase in falls rate. The nature and extent of lockdowns implemented for infection control in RAC need to balance multiple potential adverse effects. Factors which facilitated resilience during this period require exploration in future research.
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Acidentes por Quedas , COVID-19 , Instituição de Longa Permanência para Idosos , SARS-CoV-2 , Humanos , Acidentes por Quedas/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Masculino , Feminino , Idoso , Estudos Longitudinais , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Austrália/epidemiologia , Idoso de 80 Anos ou mais , Hospitalização/estatística & dados numéricos , Quarentena , Pandemias , Casas de Saúde/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodosRESUMO
In late 2020, the focus of the global effort against the COVID-19 pandemic centered around the development of a vaccine, when reports of a mutated SARS-CoV-2 virus variant in a population of 17 million farmed mink came from Denmark, threatening to jeopardize this effort. Spillover infections of the new variant between mink and humans were feared to threaten the efficacy of upcoming vaccines. In this study the ensuing short-lived yet stringent lockdowns imposed in 7 of the countries 98 municipalities are analysed for their effectiveness to reduce SARS-CoV-2 infections. Synthetic counterfactuals are created for each of these municipalities using a weighted average combination of the remaining municipalities not targeted by the stringent measures. This allows for a clear overview regarding the development of test-positivity rates, citizen mobility behaviours and lastly daily infection numbers in response to the restrictions. The findings show that these targeted, short-term lockdowns significantly curtailed further infections, demonstrating a marked decrease, first in citizens mobility and then in daily cases when compared to their synthetic counterfactuals. Overall, the estimates indicate average reductions to infection numbers to be around 31%. This study underscores the potential of strict, yet severe lockdowns in breaking ongoing infection dynamics, by utilising a rare quasi-experimental design case that avoids bias introduced through treatment selection.
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COVID-19 , Cidades , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , COVID-19/transmissão , Dinamarca/epidemiologia , Humanos , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/genética , Animais , Quarentena , Vison/virologia , Controle de Doenças Transmissíveis/métodos , Pandemias/prevenção & controleRESUMO
This perspective summarises and explains the long-term surveillance framework 2021-2027 for infectious diseases in the European Union/European Economic Area (EU/EEA) published in April 2023. It shows how shortcomings in the areas of public health focus, vigilance and resilience will be addressed through specific strategies in the coming years and how these strategies will lead to stronger surveillance systems for early detection and monitoring of public health threats as well as informing their effective prevention and control. A sharper public health focus is expected from a more targeted list of notifiable diseases, strictly public-health-objective-driven surveillance standards, and consequently, leaner surveillance systems. Vigilance should improve through mandatory event reporting, more automated epidemic intelligence processing and increased use of genomic surveillance. Finally, EU/EEA surveillance systems should become more resilient by modernising the underlying information technology infrastructure, expanding the influenza sentinel surveillance system to other respiratory viruses for better pandemic preparedness, and increasingly exploiting potentially more robust alternative data sources, such as electronic health records and wastewater surveillance. Continued close collaboration across EU/EEA countries will be key to ensuring the full implementation of this surveillance framework and more effective disease prevention and control.
Assuntos
Doenças Transmissíveis , União Europeia , Saúde Pública , Humanos , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/diagnóstico , Vigilância da População , Europa (Continente)/epidemiologia , Surtos de Doenças/prevenção & controle , Vigilância de Evento Sentinela , Controle de Doenças Transmissíveis/métodos , Vigilância em Saúde Pública/métodosRESUMO
This study aims to quantify the effectiveness of lockdown as a non-pharmacological solution for managing the COVID-19 pandemic. Daily COVID-19 death counts were collected for four states: California, Georgia, New Jersey, and South Carolina. The effectiveness of the lockdown was studied and the number of people saved during 7 days was evaluated. Five neural network models (MLP, FFNN, CFNN, ENN, and NARX) were implemented, and the results indicate that FFNN is the best prediction model. Based on this model, the total number of survivors over a 7-day period is 211, 270, 989, and 60 in California, Georgia, New Jersey, and South Carolina, respectively. The coefficients and weights of the FFNN for each state differ due to various factors, including socio-demographic conditions and the behavior of citizens towards lockdown laws. New Jersey and South Carolina have the most lockdowns and the least.
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COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , South Carolina/epidemiologia , Estados Unidos/epidemiologia , Quarentena , New Jersey/epidemiologia , Análise Espaço-Temporal , Redes Neurais de Computação , SARS-CoV-2 , Pandemias , California/epidemiologia , Georgia/epidemiologia , Controle de Doenças Transmissíveis/métodosRESUMO
This case study describes the experience of the German Permanent Working Group of Competence and Treatment Centers for High Consequence Infectious Diseases, known as STAKOB (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger). STAKOB brings together public health authorities (competence centers) and high-level isolation units (treatment centers) to collaborate on the clinical management of high-consequence infectious diseases (HCIDs) and emerging infectious diseases. The network is coordinated by the Robert Koch Institute, Germany's federal public health institute. The main tasks of STAKOB are to strengthen HCID clinical and public health management and increase expert knowledge on HCID and non-HCID emerging infectious diseases in Germany. STAKOB enables the exchange of knowledge and experiences; development of guidelines on infection prevention and control measures, clinical management, and therapy; and support for the World Health Organization and other outbreak responses internationally. The past years have shown how important the STAKOB network is for Germany-not only in providing critical care for HCID cases but also increasing capacity to support public health and clinical management of emerging infectious disease cases. However, maintaining several high-level isolation units in Germany requires a high commitment of financial, material, and human resources. Due to the rarity of HCID and emerging infectious disease events, maintaining the appropriate level of preparedness and ensuring sufficient investments is an ongoing struggle. Nevertheless, it is essential to have a network ready to react to HCID and non-HCID emerging infectious diseases in times of a changing biosecurity and infectious landscape.
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Doenças Transmissíveis Emergentes , Humanos , Alemanha , Doenças Transmissíveis Emergentes/prevenção & controle , Surtos de Doenças/prevenção & controle , Saúde Pública , Isolamento de Pacientes , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis , Controle de Infecções/métodos , Controle de Infecções/organização & administraçãoRESUMO
Infectious disease physicians in England have been diagnosing and managing occasional cases of viral hemorrhagic fever since 1971, including the United Kingdom's first case of Ebola virus disease in 1976. Specialist isolation facilities to provide safe and effective care have been present since that time. Following the emergence of Middle East respiratory syndrome (MERS) in 2012, and the avian influenza A (H7N9) outbreak in 2013, and the 2014-2016 Ebola virus disease outbreak in West Africa, clinical and public health preparedness and response pathways in England have been strengthened for these types of diseases, now called high-consequence infectious diseases (HCIDs). The HCID program, led by NHS England and Public Health England between 2016 and 2018, helped to deliver these enhancements, which have since been used on multiple occasions for new UK cases and outbreaks of MERS, mpox, avian influenza, and Lassa fever. Additionally, HCID pathways were activated for COVID-19 during the first 3 months of 2020, before the pandemic had been declared and little was known about COVID-19 but HCID status had been assigned temporarily to COVID-19 as a precaution. The HCID program also led to the commissioning of a network of new airborne HCID treatment centers in England, to supplement the existing network of contact HCID treatment centers, which includes the United Kingdom's only 2 high-level isolation units. In this case study, the authors describe the airborne and contact HCID treatment center networks in England, including their formation and structures, their approach to safe and effective clinical management of patients with HCIDs in the United Kingdom, and challenges they may face going forward.
Assuntos
COVID-19 , Humanos , Inglaterra/epidemiologia , COVID-19/epidemiologia , Hospitalização , Surtos de Doenças/prevenção & controle , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/terapia , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/métodos , SARS-CoV-2 , Influenza Humana/epidemiologiaRESUMO
BACKGROUND/AIMS: This study aimed to assess the impact of non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic on nationally notifiable infectious diseases (NNIDs) in South Korea. METHODS: Long-term data on seven NNIDs from 2018 to 2021 were analyzed to identify trends and change points using a change point detection technique. The timings of the NPI implementations were compared to the identified change points to determine their association. RESULTS: Varicella, mumps, and scarlet fever showed a significant decrease in incidence following the implementation of NPIs during the COVID-19 pandemic. These diseases, which are primarily transmitted through respiratory droplets, demonstrated a clear response to NPIs. However, carbapenem-resistant Enterobacterales (CRE) showed an increasing trend unrelated to the timing of NPI implementation, suggesting the complex nature of controlling healthcare-associated infections. Hepatitis A, hepatitis C, and scrub typhus did not show significant changes associated with NPIs, likely due to their non-respiratory route of transmission. CONCLUSION: NPIs effectively controlled NNIDs, particularly those transmitted through respiratory infections. However, the impact varied depending on the disease. Understanding the effectiveness and limitations of NPIs is crucial for developing comprehensive public health strategies during infectious disease outbreaks.
Assuntos
COVID-19 , Humanos , República da Coreia/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/diagnóstico , Controle de Doenças Transmissíveis/métodos , SARS-CoV-2 , IncidênciaRESUMO
Adequate infectious disease-specific health literacy (IDSHL) is of benefit to residents in dealing with infectious diseases. This study aimed to investigate the methods by which residents acquire knowledge about infectious disease prevention and control (IDPC knowledge) so as to find effective health education methods used to improve residents' IDSHL level. In 2022, a cross-sectional study was conducted in Shandong Province, China. Participants were recruited from rural areas by multistage sampling. The IDPC knowledge cognitive questionnaire, as a reliable and valid tool, was applied to data collection and to investigate the participants' IDPC knowledge. Chi-square analysis was utilized to analyze the differences in possession level of IDSHL between different subgroups. The relationship between demographic factors and methods to acquire IDPC knowledge was also examined by chi-square analysis. The possession rate of adequate IDSHL among the total 2283 participants was 31.80%. There was a significant association between IDSHL level and socio-demographic factors, including age (Pâ <â .001), sex (Pâ =â .02), education (Pâ <â .001), occupation (Pâ <â .001), annual family income (Pâ <â .001), whether to use smartphones (Pâ <â .001), whether to browse WeChat on smartphones (Pâ <â .001), and whether to browse apps on smartphones except WeChat (Pâ <â .001). Univariate analysis showed that whether to adopt specific methods, including television (Pâ =â .02), WeChat on smartphones (Pâ <â .001), propaganda of infectious disease prevention and control (Pâ <â .001), and doctor's advice (Pâ <â .001) to acquire IDPC knowledge had significant associations with IDSHL level. Age (Pâ <â .001), education (Pâ <â .05), occupation (Pâ <â .05), and annual family income (Pâ <â .01) were associated with methods to acquire IDPC knowledge. The rural residents' adequate IDSHL in Shandong Province, China, was not optimistic. The combination of traditional methods and Internet publicity platforms should take greater responsibility for IDSHL health education among rural populations.
Assuntos
Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde , População Rural , Humanos , China , Masculino , Feminino , Letramento em Saúde/métodos , Estudos Transversais , Adulto , População Rural/estatística & dados numéricos , Pessoa de Meia-Idade , Educação em Saúde/métodos , Inquéritos e Questionários , Adulto Jovem , Doenças Transmissíveis/epidemiologia , Idoso , Controle de Doenças Transmissíveis/métodosRESUMO
PURPOSE: Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor - COV-PPM, and the Oxford Covid-19 Government Response Tracker - OxCGRT. METHODS: NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5-25, and C4-C6, weeks 35-52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). RESULTS: During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. CONCLUSION: In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).
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COVID-19 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/mortalidade , Europa (Continente)/epidemiologia , Incidência , SARS-CoV-2 , Pandemias/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Distanciamento FísicoRESUMO
After the many failures in the control of the COVID-19 pandemic, identifying robust principles of epidemic control will be key in future preparedness. In this work, we propose an optimal control model of an age-of-infection transmission model under a two-phase control regime where social distancing is the only available control tool in the first phase, while the second phase also benefits from the arrival of vaccines. We analyzed the problem by an ad-hoc numerical algorithm under a strong hypothesis implying a high degree of prioritization to the protection of health from the epidemic attack, which we termed the "low attack rate" hypothesis. The outputs of the model were also compared with the data from the Italian COVID-19 experience to provide a crude assessment of the goodness of the enacted interventions prior to the onset of the Omicron variant.
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Algoritmos , COVID-19 , Pandemias , Distanciamento Físico , SARS-CoV-2 , Vacinação , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/transmissão , Humanos , Itália/epidemiologia , SARS-CoV-2/imunologia , Pandemias/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Simulação por Computador , Controle de Doenças Transmissíveis/métodos , Política de Saúde , QuarentenaRESUMO
We modeled the impact of local vaccine mandates on the spread of vaccine-preventable infectious diseases, which in the absence of vaccines will mainly affect children. Examples of such diseases are measles, rubella, mumps, and pertussis. To model the spread of the pathogen, we used a stochastic SIR (susceptible, infectious, recovered) model with two levels of mixing in a closed population, often referred to as the household model. In this model, individuals make local contacts within a specific small subgroup of the population (e.g., within a household or a school class), while they also make global contacts with random people in the population at a much lower rate than the rate of local contacts. We considered what would happen if schools were given freedom to impose vaccine mandates on all of their pupils, except for the pupils that were exempt from vaccination because of medical reasons. We investigated first how such a mandate affected the probability of an outbreak of a disease. Furthermore, we focused on the probability that a pupil that was medically exempt from vaccination, would get infected during an outbreak. We showed that if the population vaccine coverage was close to the herd-immunity level, then both probabilities may increase if local vaccine mandates were implemented. This was caused by unvaccinated pupils possibly being moved to schools without mandates.